Laserfiche WebLink
FtkKtkkittttC•Cttt2t�t2k2CZ tittCtkiCtNktt�ttCtNCittkCtttkt CEI `�' E D <br /> ►PPLICItIOY FOR PERMIT �: SAN JO1pUltl LOCAL HEALTH DIStRICTt: <br /> 111 Y <br /> k: UNDERGROUND TANK p: 1601 1 HILILT08 AVE., STOCKTON C11: 0 C T 2 6 1989 <br /> e CLOSURE OR ABANDONMENT t: Telephone (209) 468-3420 It ENVIRONMENTAL HEALTH <br /> tttntkktt€kactt�tttktttkLtitYNtxkktttttttkttC2t2attkkitttatltat: PERMIT/SE�l i-FFS. <br /> ND <br /> THISIPITION FORRMIT PISH90ED11SRMPORIVY FROM THE CLOSURE <br /> APPROVILRDITB�DODORNOT NT I1I118CIY 111E OF ESeADIDUAREISYIRINDICITESPERMIIT TYPEIIELOW:tLI�f <br /> X REMOVAL TEMPORARY CLOSURE _ 1011DONKENT IN PLACE <br /> TCIDDRISS <br /> S[tR t PROJ8C1 CONTACT A TELEPHONE I Spence Poore <br /> ILITY NAME East Bay Municipal Utility Di tPHONI I ( 209 ) 463-2463 <br /> — —.. - -------- <br /> West Main Street Stockton, CASS Stilly Los Angeles _ <br /> I PRONE t <br /> f OWNEI/OPIIATOI <br /> T <br /> Spence Poore (209) 463-2463 <br /> C COITRICtOR LIMECottle Engineering PHONE 1 ( 415) 754-9935 <br /> 0 C► LIC I CLASS <br /> I COYTRICTOR IDDIESS P.O. gox 163 Antioch, CA 481444 A <br /> 1 -- R <br /> R INSURER NORK.COMP.ITransamerica Workers' omp. <br /> Fairmont Insurance <br /> I — <br /> C IIRI DISTRICTStockton Fire �PERMIT 1/I11SPTI #12829 <br /> T PH <br /> 0 LIBOIITOIT NINE Trace Analysis I — 783-6960 <br /> ONEI <br /> R <br /> SIMPLIIG FIRM' Trace Analysis SAMPLING METWODone at each end of tank <br /> �_yp�1![1p(pp1ITlNpNA�yINpI9YpKpNlI0YldIYYIpD_tNpYN1NYionow NNYdD,I'JW'L'MS11E -- <br /> CHEMICILS lST_ORED_CU <br /> RRENT6 CH <br /> EMICIL_S S <br /> TORED PRI2IOUSL <br /> 1000 unlc�a asoli e <br /> 1,000NLIST ADOIT[ORIL 1191 INFORMATION IS NEEDED ON SEPARITS PORN <br /> IIdIIDIIIUIIdIp!iYJldlddlii4WYdIIHYIdYHNYIIYHSktlI!YIHYdJYNIdIlYYY7,dVIJiIIIM'Y4!dl�'CIIdIdIYJ'lip!WN:YIINYIHWiNHIHIIII'JNtldYldYddlNldMl6'WiIWIddIDMWWYYIHWL'„ <br /> P ___ APPROVED _ IPPROVBD WITH CONDITIONS —__ DISAPPROVED <br /> / (318 ItTICNMEYt WITH CONDITIONS) <br /> PLIN IEI[INEIS 111111 - D►TE^-_______ l <br /> 1 <br /> u��Y�Nmu�rauw <br /> IPPLICINT MUST PERFORM ILL WORK 11 ACCORDANCE WITH SAM JOIQUIN COUNTY ORDIN/LACES, STITH LIWS, AND RULES IND RBCULItIONS <br /> OF ANE SIN JOAQUIN LOCAL HEALTH DISTRICT. OWNER OR LICENSED AGENT'S SIGNITURR CERTIFIES THE FOLLOWING: 'I CERTIFY THAT <br /> IN THE PEIFORMINCS OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I S4ILL HOT EMPLOY ANY PERSON IN SUCH MANNER 1S TO BECOM <br /> SUBJECT TO YORKER'S COMPIISITION LIPS OF CALIFORNIA.' COMTRICTOI'S HIRING OR SUECONTRACTING SIGNATURE CERTIFIES THE <br /> FOLLOWING: '1 CERTIFY ?HIT II THE PERFORMANCE OF Till NOR[ FOR WHICH THIS PERMIT IS ISSUED, I SHhLL EMPLOY PERSONS SUOJEC <br /> TO NORKIR'S COMPENS/TION LIES OF CALIFORNIA. <br /> CALL FOR INSPECTIONS T LE T 40 NOU[2S IN ADVA�Nr/CE <br /> Aoop <br /> SIGNEDJIM, _ ,_ DATI_Z�= __�__� <br /> OFFICE USIUSI ONL�12/81 <br /> SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS <br /> SNIEPS I I COMP I ILOC CODE IDIST CODBI IMOONT DUE I AMOUNT RCVD I CKIICASH I RCYO By 1 0119 RCVD I PERMIT 1 <br />